Congenital melanocytic naevi (CMN) appear in approximately 2.6% of Caucasians. There is a major demand for treatment but no vital indication. Laser therapy, curettage and excision are available treatment modalities, but there is no ideal treatment with documented long-term effect and without side effects, and the level of evidence for the treatment options is generally low. The risk of malignancy has probably been overestimated, and furthermore new research shows that untreated CMN often show spontaneous lightening. We review the literature for pros and cons of different treatments.